The Patient Promise: Healers pledge to lead by example

“Physician, heal thyself. And also, get at least 30 minutes of moderate exercise per day, eat nutritious whole foods, and ease some of your stress.”

That’s not quite how the biblical quote reads.  But Johns Hopkins medical students Shiv Gaglani and David Gatz are hoping doctors and nurses will heed those words nevertheless. They’ve begun an initiative called The Patient Promise that urges current and future healthcare professionals to pledge that they’ll adopt “healthy lifestyle behaviors” – physical activity, balanced nutrition, and stress management — to benefit themselves and, by extension, their patients.

Shiv Gaglani and David Gatz

The two came up with the idea after watching, with dismay, their own health decline due to the stress and long working hours of their first year of medical school. They also noted studies showing that some 63 percent of male physicians and 55 percent of female nurses are overweight or obese, what the health industry calls “tight white coat syndrome.”

That could spell trouble for patients; a study in the January issue of the journal Obesity showed that overweight or obese physicians talked to obese patients about weight management for only 18 percent of available opportunities; in doctors with a healthy BMI, that number rose to 30 percent — still plenty of room for improvement, though. Conversely, other studies show that doctors with healthier habits are more likely to counsel their patients to adopt preventive lifestyle behaviors.

Another Patient Promise goal is to combat weight bias discrimination. “Research suggests that medical students are more likely to view the obese and smokers as lazy or apathetic, which can show up in how they care for such patients down the road,” says Gaglani, who adds that he has witnessed such behavior in clinical settings.

Those pledging the Promise agree to, instead, “…identify and guard myself from potential prejudices against my patient based on unhealthy behaviors, recognizing the often complex origins of these habits.”

Since the program launched in June, 642 medical professionals and students from 50 institutions around the country have made the pledge. Participants monitor themselves, but Gaglani says he’s received a great deal of positive feedback, and that a number of students who’ve signed the promise have since lost weight or quit smoking — including himself.

“Personally, it affects my daily habits as well as my interactions with patients,” he says. “I had gained about 10 pounds during my first year of med school and have since lost those after committing to the Promise. I also have tried learning more about nutrition – something not emphasized at most medical schools – so that I can optimize my own, and my patients’, diet.

“It’s kept me honest with my own lifestyle,” he says.